We estimated infant and early child mortality rates among Palestinian refugees using maternal and child services in Jordan, Gaza, Lebanon, and Syria. Early childhood mortality per 1000 live births was 35 in Jordan, 36 in Gaza, 37 in Lebanon, and 32 in Syria. Infant mortality rates were 32 in Jordan, 33 in Gaza, 35 in Lebanon, and 29 in Syria.Since 1950, the UN Relief and Works Agency for Palestine Refugees in the Near East has provided education, health, and relief and social services to registered Palestinian refugees in Jordan, Gaza, the West Bank, Lebanon, and Syria. This study estimated infant and early child mortality rates among Palestinian refugees who attended the agency's primary health care facilities. Using a modified version of the Preceding Birth Technique to estimate early childhood and infant mortality rates, it was noted that infant mortality rate was highest in Lebanon, followed by Gaza, Jordan, and Syria. Early childhood mortality per 1000 live births was 35 in Jordan, 36 in Gaza, 37 in Lebanon, and 32 in Syria. Infant mortality rates registered in Jordan were 32, 33 in Gaza, 35 in Lebanon, and 29 in Syria.